Susan R. Berg, MFT

Individual provider Active NPI Marriage & Family Therapist · Cotati, CA

NPI 1205924743 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1205924743
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
MFC17222 (CA)
Practice address
315 E Cotati Ave Ste G
Cotati, CA 94931-7801
Phone
(707) 792-9716
Fax
(707) 794-8271
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MFC17222CAMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC17222 CA Yes

Addresses

Primary practice location

315 E Cotati Ave Ste G
Cotati, CA 94931-7801

Mailing address

315 E. Cotati Ave. Suite G
Cotati, CA 94931
Phone (707) 792-9716

Other providers in Cotati, CA

All providers in Cotati, CA · Marriage & Family Therapist in California

Sources for this page

Verify at the official NPI Registry.